MCO's

Kentucky’s State Auditor Adam Edelen is concerned about the Commonwealth’s ability support an added 300,000 resident’s to its Medicaid program. Expanded Medicaid coverage next year comes as part of the rollout of the Affordable Care Act.

Kentucky State Auditor Adam Edelen says there's a lack of oversight by the Cabinet for Health and Family Services over Medicaid Managed Care Organizations.

In the second part of the statewide audit released today, Edelen says the MCOs didn't provide enough information to ensure grievances from members and providers were handled timely or that federal compliance requirements were met.

A bill moving Medicaid late payment claims to the Department of Insurance appears to have some support in the state Senate.

House Bill 5 would take prompt pay issues with the Medicaid managed care system and put it through the Insurance Department's current claims process. Currently, the Cabinet for Health and Family Services deal with late claims.

As the fallout continues from the announced departure of statewide Medicaid operator Kentucky Spirit, many other Medicaid operators are already looking to take their place.

Kentucky Spirit announced last week they would break their contract with the state early. State officials say they won’t re-open those statewide contracts to replace Kentucky Spirit until the current contracts expire.